Treatment of intradermal and superficial hemangiomas in children

V.F. Rybalchenko, I.G. Rybalchenko, Yu.G. Demidenko

Abstract

Background. Hemangiomas are benign tumors. Among various neoplasms in children, they make up to 80 %; meanwhile, in newborns — 0.3–2.6 %, and at the age of 1 year — up to 10–12 %. Objective: to improve the results of intradermal and superficial treatment in children due to the improvement of minimally invasive surgical technologies. Materials and methods. 43 children aged 1 to 12 years were examined and underwent treatment (among them — 29 (67.4 %) girls). Dynamic monitoring was performed in 11 (25.6 %) patients. In 32 (74.4 %) children, minimally invasive treatment was performed. Results. The following localization of hemangiomas was established: the scalp — 4 (9.3 %), the nose — 5 (11.6 %), the cheek — 4 (9.3 %), the trunk — 8 (18.6 %), the loins — 5 (11.6 %), the upper limbs — 9 (21 %), the lower limbs — 8 (18.6 %). Involuntary changes in hemangiomas were detected in 2 (18.1 %) children aged over 10 months, in 11 months — in 3 (27.2 %), after 12–13 months — in 5 (45.4 %), and more actively occurred from 14–16 months. Minimally invasive treatment was conducted in 32 children. In 26 patients, intradermal unipolar diathermy (Rybalchenko V.F., 1994) was used without damaging the hemangiomas from the outside. It was found that 16 (61.5 %) patients had one vessel that caused angiodysplasia, 8 (30.7 %) — two vessels, and 2 (7.8 %) — four vessels. A repeated session of intradermal unipolar diathermy was carried out in 6 (23 %) patients in whom hemangiomas were found in 2–4 vessels. In 6 patients, thermoelectrocoagulation was used. Long-term results were considered as excellent, there were no relapses. Conclusions. Involution of hemangiomas was established in 25.6 % of children in dynamic observation and monthly monitoring of parameters of the latter. When treating intradermal and superficial hemangiomas in children, it is advisable to use minimally invasive surgical techniques: intradermal unipolar diathermy and thermoelectrocoagulation, which was effective in 74.4 % of sick children.